Preventive Regime Research Articles

Vascular density profile of rat mammary carcinomas induced by 1-methyl-1-nitrosourea: implications for the investigation of angiogenesis.

Given the mounting interest in studying the effects of various cancer preventive regimes on the angiogenic process in autochthonously growing mammary tumors, the experiment reported here was conducted to identify factors that should be considered in the collection of data from experiments in which a primary endpoint is the measurement of blood vessel density as a reflection of angiogenic activity. Female Sprague-Dawley rats were injected i.p. with 50 mg 1-methyl-1-nitrosourea (MNU)/kg body weight at 21 days of age. Tumor-bearing rats were killed 35 days post-carcinogen. Immunohistochemical detection of blood vessels using antiserum directed against the CD31 epitope was performed on paraffin sections of 36 carcinomas representing four histological types. Census counting was used to detect all blood vessels that were subsequently divided into one of five vessel size categories. Vessels were counted in both the intra-tumoral region and in a 50 microm width band of mammary tissue circumscribing each tumor; the circumscribed area was referred to as the extra-tumoral region. Vascular density was reported in units of vessel counts or vessel area per unit of assessed area. Overall, vascular density was observed to be highly variable and was not affected by tumor histology. Vascular density in the extra-tumoral region was significantly higher than in the intra-tumoral region. Correlation analyses indicated that similar information was obtained when vascular density was reported as either vessel counts or vessel area; however, correlations across vessel size categories and between the intra-tumoral and extra-tumoral regions were low and generally not statistically significant. Collectively, the data provide a complete description of vascularization in autochthonously growing mammary tumors, and a reference for comparison in studies of various cancer preventive agents that modulate the angiogenic process.

Actico: a short-stretch bandage in venous leg ulcer management.

Actico compression bandage system (Activa Healthcare) completes the prevention and treatment regime of venous leg ulcer management. Actico gives the patient comfort by being a simple two-layer compression bandage system that is also effective and which stays in place because of its cohesive nature. This product focus looks at the impact of venous leg ulcers, the use of compression and focuses on short-stretch bandages and the Actico bandage system.

Transnational environmental obligations: locating new spaces of accountability in a post‐Westphalian global order

The growth of transnational environmental harm is not only leading to new obligations between states, it is also recasting democratic accountability for the crossboundary environmental performance of public and private actors. Informed by pragmatist ideas on public discourse, I propose a conceptual schema for understanding the moral geography of these new transnational environmental obligations: they mark out non‐territorial spaces of public communication delimited according to moral precepts of harm prevention, inclusiveness and impartiality. I outline how the recognition of transnational affected publics is reconstituting and rescaling environmental accountability within international regimes of harm prevention and liability. The critical geopolitical challenge in institutionalizing non‐territorial domains of environmental accountability will be the mapping and empowerment of transnational affected publics.

Quantitative light-induced fluorescence (QLF): a method for assessment of incipient caries lesions.

To review the literature on validation and application of the quantitative light-induced fluorescence (QLF) method for quantitative assessment of early enamel lesions in vivo and in vitro. QLF uses light with wavelengths around 405 nm to excite yellow fluorescence at wavelengths above 520 nm. Its diagnostic capacity is based on the mechanism that the intensity of natural fluorescence of a tooth is decreased by scattering due to a caries lesion. The equipment, the data processing and the interaction between equipment and operator are described. The method has been validated by many authors; the results are presented and compared. For artificial lesions, the validation line is curved. For larger mineral losses, the curve is linear with a slope of 10% fluorescence loss corresponding with a mineral loss of 0.15 kg x m(-2). For lesions caused by natural caries, it is tentatively concluded that fluorescence loss is linear to mineral loss with a slope similar to that of artificial lesions. Reliability and reproducibility have been tested in vivo and show interexaminer values of the interclass correlation coefficient, r, of 0.93<r<0.99. Confounding factors are inadequate reconstruction of sound fluorescence values and drying of the lesion before or during measurement. In vivo application showed that statistically significant changes between different preventive regimes could be proven in only 6 months of study time. QLF offers a potential tool to reduce the time needed for clinical research. Its objectivity will prove useful in epidemiological surveys. QLF provides visual and quantitative feedback to patients.

The development and demonstration of integrated models for the evaluation of severe accident management strategies—SAMEM

This study is concerned with the further development of integrated models for the assessment of existing and potential severe accident management (SAM) measures. This paper provides a brief summary of these models, based on Probabilistic Safety Assessment (PSA) methods and the Risk Oriented Accident Analysis Methodology (ROAAM) approach, and their application to a number of case studies spanning both preventive and mitigative accident management regimes. In the course of this study it became evident that the starting point to guide the selection of methodology and any further improvement is the intended application. Accordingly, such features as the type and area of application and the confidence requirement are addressed in this project. The application of an integrated ROAAM approach led to the implementation, at the Loviisa NPP, of a hydrogen mitigation strategy, which requires substantial plant modifications. A revised level 2 PSA model was applied to the Sizewell B NPP to assess the feasibility of the in-vessel retention strategy. Similarly the application of PSA based models was extended to the Barseback and Ringhals 2 NPPs to improve the emergency operating procedures, notably actions related to manual operations. A human reliability analysis based on the Human Cognitive Reliability (HCR) and Technique For Human Error Rate (THERP) models was applied to a case study addressing secondary and primary bleed and feed procedures. Some aspects pertinent to the quantification of severe accident phenomena were further examined in this project. A comparison of the applications of PSA based approach and ROAAM to two severe accident issues, viz hydrogen combustion and in-vessel retention, was made. A general conclusion is that there is no requirement for further major development of the PSA and ROAAM methodologies in the modelling of SAM strategies for a variety of applications as far as the technical aspects are concerned. As is demonstrated in this project, the generic modelling framework was refined to enable a number of applications. Some recommendations have also been made regarding the applicability of these approaches to existing operating reactors and future reactors. The need for further research and development in the area of human reliability quantification was identified.

Approaches to ethnic conflict and the protection of human rights in post‐communist Europe: The need for preventive diplomacy

Ethnic conflict in post‐communist states is often caused by human rights abuses stemming from the lack of democratic institutions and other politico‐legal mechanisms for resolving inter‐ethnic disputes. This article compares the legal approach to the management of ethnic conflict and the protection of human rights in post‐communist states with the political approach of the Organization for Security and Cooperation in Europe (OSCE), with specific reference to Estonia and Albania. It concludes that while the Council of Europe often sets the standards and norms regarding the treatment of minorities, it is the OSCE, especially through the work of the High Commissioner on National Minorities, that has the capability to accommodate ethnic tensions more effectively. Post‐Cold War conflicts require new means of resolution: quiet preventive diplomacy and human rights protection are the foundations for managing multi‐ethnic tensions before they become violent. In short, a multi‐dimensional preventive diplomacy regime is needed that will capitalize on the comparative strengths of both legal and political approaches.

Dollar Spot and Brown Patch Fungicide Management Strategies in Four Creeping Bentgrass Cultivars

New creeping bentgrass (Agrostis palustris Huds.) cultivars should be thoroughly evaluated for disease resistance and fungicide application strategies for inclusion in integrated pest management plans. Our objectives were to evaluate dollar spot (Sclerotinia homoeocarpa F.T. Bennett) and brown patch (Rhizoctonia solani Kühn) severity, and turf quality of ‘L‐93’, ‘Penncross’, ‘Providence’, and ‘Crenshaw’ creeping bentgrass managed using preventive, curative, and weather model‐based fungicide application strategies. This field study was conducted on a sand‐based putting green in Manhattan, KS, from 1997 through 1999. Nonfungicide‐treated L‐93 exhibited greatest resistance to dollar spot; Penncross and Providence were intermediate; and Crenshaw was most susceptible. Crenshaw exhibited greater brown patch susceptibility than other cultivars in 1998, but was similar to L‐93 in 1999. Greater flexibility in imposing a disease control strategy was afforded by using a disease‐resistant (i.e., L‐93), rather than a disease‐susceptible (i.e., Crenshaw) cultivar. Dollar spot was controlled in L‐93 using preventive fungicide applications on 14‐ or 28‐d intervals, preventive low‐rate applications of chlorothalonil (tetrachloroisophthalonitrile, 3.5 kg a.i. ha−1) every 7 d, or a curative fungicide application when an increase in the disease was observed. In Crenshaw, only the 14‐d preventive fungicide regime effectively controlled dollar spot. Considering all cultivars across the 3‐yr period, fewer fungicide applications were made using a curative (n = 11–17) than a preventive (n = 30) strategy. The curative strategy was effective when dollar spot, but not when brown patch was the primary disease.

Transboundary Environmental Governance and the Baia Mare Cyanide Spill

AbstractMining gold with the use of cyanide has always been an inherently dangerous activity requiring strict regulatory oversight and the application of appropriate technology to prevent environmental harm. The cyanide spill from the Aurul S.A. gold-mining operation in Baia Mare, Romania, was a warning to the international community that legal and institutional regimes that should prevent and respond to such accidents may as yet not be fully developed, especially in countries in transition. In particular, the international legal regimes for industrial-accident prevention, liability, and foreign direct investment must be considered as a whole in order to identify gaps and weaknesses in the system that should be addressed in the effort to protect human health and the environment from such accidents. In addition, the gap between legal requirements and commitment to, and capacity for, implementation—especially in transition countries—must be addressed.This article addresses the need to bring attention to the international legal implications of the Baia Mare accident. First, the article sets the stage by briefly identifying the positive responses that the accident has evoked from Romanian and international stakeholders, indicating that steps have already been taken to strengthen the institutional and legal framework governing mining operations. Then, the international legal obligations of Romania at the time of the accident are examined, followed by the identification of international conventions to which Romania was not party at the time of the accident and that could have helped prevent the accident. Gaps in the international legal regimes relevant to the accident are also identified and recommendations are made for filling them, including principles of environmental governance for foreign investors in countries in transition. Recommendations are also made for addressing the issue of implementation.The accident at Baia Mare has resulted in a number of positive responses—both domestically in Romania, as well as regionally and at a broader European level—and it is incumbent upon stakeholders to continue to expand the scope of social learning that the accident has made available. Actions taken in Romania after the spill include closer cooperation between local/regional officials and environmental nongovernmental organizations and a generally increased sensitivity among NGOs to the dangers inherent in mining activities. NGOs have now assumed watchdog and public-education roles. Responses at the European level include greater transboundary cooperation in river management and a strong push by the European Union to amend the Seveso II Directive on industrial-accident prevention to cover mining operations.Romania was not party to several key international conventions that could conceivably, if implemented, have prevented or minimized the effects of the accident at Baia Mare or provided for a more effective long-term response. These include the Convention on the Transboundary Effects of Industrial Accidents and the Convention on the Law of the Non-navigational Uses of International Watercourses. In addition to international legal instruments to which Romania was not party, there are also European Union directives that Romania has not yet transposed into domestic law. As a country seeking to join the European Union, transposition of EU legislation is a high priority for Romania. Priority should be given to the Seveso II Directive, which seeks to prevent industrial accidents, and the directive on integrated pollution prevention and control, which requires the use of the best available technology to prevent discharges.Gaps and weaknesses in international law fall into three main categories: industrial-accident prevention, liability for environmental harm, and foreign direct investment.

Effects of tomato extract on human platelet aggregation in vitro

Among all fruits tested in vitro for their anti-platelet property, tomato had the highest activity followed by grapefruit, melon, and strawberry, whereas pear and apple had little or no activity. Tomato extract (20-50 w l of 100% juice) inhibited both ADP- and collagen-induced aggregation by up to 70% but could not inhibit arachidonic acid-induced platelet aggregation and concomitant thromboxane synthesis under similar experimental conditions. The anti-platelet components (MW <1000 Da) in tomatoes are water soluble, heat stable and are concentrated in the yellow fluid around the seeds. The active fractions were separated using gel filtration and HPLC. The aqueous fraction (110 000 2 g supernatant) of tomatoes containing anti-platelet activity was subjected to gel filtration column chromatography (Biogel P2 column). The activity was fractionated into two peaks, peak-3 and peak-4 (major peak). Subsequently, peak-4 was further purified by HPLC using a reversed-phase column. NMR and mass spectroscopy studies indicated that peak F2 (obtained from peak 4) contained adenosine and cytidine. Deamination of peak F2 with adenosine deaminase almost completely abolished its anti-platelet activity, confirming the presence of adenosine in this fraction. In comparison, deamination of peak-4 resulted in only partial loss of inhibitory activity while the activity of peak-3 remained unaffected. These results indicate that tomatoes contain anti-platelet compounds in addition to adenosine. Unlike aspirin, the tomato-derived compounds inhibit thrombin-induced platelet aggregation. All these data indicate that tomato contains very potent anti-platelet components, and consuming tomatoes might be beneficial both as a preventive and therapeutic regime for cardiovascular disease.

Adherence to health messages: A social psychological perspective

Non-adherence to regimes recommended by health practitioners is prevalent in the health and safety area. Even the most effective of interventions does not tend to lead to substantial improvements in adherence. This paper reviews models from the health psychology sphere that predict which factors might lead people to practice health-enhancing behaviours. In terms of health messages, the paper evaluates the methods of persuasion found to be most successful. It provides an analysis of a successful intervention, in which a target audience was motivated to adopt a health-enhancing choice. The paper concludes by examining the principles that can be drawn from successful interventions, in terms of changing a target audience's health behaviours. The focus is on those that can be applied to situations in which a health practitioner hopes to convince the patient to adhere to a preventive regime.

The principles of environmental law as they affect engineering decision making

The ad hoc development of the law in relation to the environment is outlined leading to the identification of principles which are said to reflect the ethos of environmental law. The implementation of these principles in legislation and in regulations under preparation to satisfy European Directives, and the influence of environmental management systems is summarised. The article concludes with a description of the effect of the pending pollution prevention and control regime on a typical process plant installation project.

Biomaterials and cardiovascular devices.

In the field of cardiovascular surgery there is presently a lack of biomaterials possessing essential characteristics of the native tissue or organ which is to be replaced. This paper describes various biomaterials that have been introduced into the circulatory system and the complex reactions that subsequently occur. The risk of infection is also discussed as well as prevention and treatment regimes that can be used. Examples of future biomaterial development are outlined in an attempt to achieve biocompatibility.

Allocating resources in health care: alternative approaches to measuring needs in resource allocation formula in Ontario

Maintaining or improving the welfare of the population is a complex issue involving individual and collective actions and institutions. Despite questions regarding the relevance of health care systems to these aims, they remain vital policy and treatment arenas with respect to curative and preventative regimes. As a component of social welfare, health care resources should be distributed equitably, according to need for health care. This paper evaluates alternative indicators of health status within Ontario against self-reported health as a means of allocating health care resources. Proxies of need for health care include standardized mortality ratios (based on the population aged 0–64) and a socioeconomic based indicator. Mortality indicators are found to be more closely correlated with self-reported health status than the socioeconomic indicator, suggesting that mortality is better able to reflect variations in health status and health care needs.

Human and horse medicine among some Native American groups

Because Plains Indians, as well as some other groups of Native Americans, generally perceived people and animals as closely related, medical therapies and preventive regimes in human and veterinary medical practice often overlapped. The sense of partnership that mounted people shared with their horses dictated that it was appropriate for certain equine remedies to be similar to those used for themselves. Horses, as well as people, could possess useful knowledge in the realm of curing. Reciprocity between humankind and nature was expressed by the interactive healing powers of people and horses as well as by recorded examples of the connection that existed between human and equine health maintenance measures and medical procedures.

Parturient haemoglobinuria in buffaloes--a review.

Parturient haemoglobinuria is a disease of economic importance in buffalo rearing countries in general and in India, Pakistan and Egypt in particular. This study reviews the information on aetiology, epidemiology, clinical aspects and treatment of parturient haemoglobinuria in buffaloes. The body of literature reviewed suggests that phosphorus deficiency in the diet of affected animals plays a major role in causing this disease, although the precise mechanism involved is complex. The possible factors involved and their interplay, plus the clinical picture of affected animals and the results of different preventive and therapeutic regimes are discussed. The study also identifies areas for further research.

Preventing violent conflicts: a strategy for preventive diplomacy

In this balanced and comprehensive analysis--the first of its kind--Michael Lund defines early warning and preventive diplomacy; assesses, after reviewing several recent preventive efforts, who does it, what methods work, and why; and suggests how multilateral and national entities (especially the U.S. government) can overcome operational challenges to effective preventive action.The book concludes by sketching the outlines of a more systematic, global preventive regime, one that draws on the strengths of individual states, the United Nations, regional organizations, and NGOs.

A reassessment of the dental health of children attending Oral Orthopaedic Clinic at Glasgow Dental Hospital and School

Children attending the Department of Oral Orthopaedics are actively involved in a preventive programme to improve their dental health. The value of the preventive regime was assessed in the early 1...

323 Risk assessment and risk management in familial predisposition to breast cancer

Risk factors for breast cancer are usually expressed as relative rates, but is essential in counselling women that the relative risks are translated into absolute values in order for women to plan their lives appropriately and in the cost benefit analysis of the various preventive regimes that might be considered. Thus at one extreme there might be a 30 year old woman whose mother developed breast cancer at around the menopause and has a late first pregnancy whose relative risk might be considered 2.5 which in absolute terms might translate into a 5% hazard for developing breast cancer before the age of 50. At the other extreme would be a woman of a similar age where genetic linkage studies suggest there is a dominant gene inherited through the germ line with an 80% pene-trance. She would have a 40% chance of developing breast cancer before the age of 60 and thus about a 1 in 5 chance of dying of the disease. In the first instance with appropriate counselling the woman in question might choose to live with the risk whereas at the other extreme the woman might rationally accept the offer of prophylactic mastectomy. Of course these decisions become somewhat easier once genetic testing becomes available. As far as interventions that might be employed prophylactic mastectomy would only be considered for these extreme cases and even this intervention cannot guarantee 100% protection. Mammographic screening for the pre-menopausal women where the familial predisposition tends to express itself is of unproven value. Finally a good prospect for intervention for familial predisposition to breast cancer would be chemoprophylaxis. Trials of tamoxifen are currently under way but these may be more appropriate to post-menopausal women. For the pre-menopausal women I am of the opinion that we will one day be able to develop a safe and effective contraceptive regimen that will incidentally reduce the risk of breast cancer.

Products for Prevention during Orthodontics

The potential for iatrogenic damage following fixed orthodontic treatment has been well documented for many years. Enamel decalcification and gingival inflammation are preventable if good practice is followed. Patients with gingivitis or active caries should not be considered for fixed orthodontics until the disease is controlled. Diet advice, oral hygiene, and topical fluorides are the basic elements of any preventive regime, and while they need to be individually tailored for each patient, fluoride mouthrinses should be routinely used by all patients with fixed appliances. The susceptibility of enamel adjacent to an orthodontic attachment remains a problem which future improvements in adhesive materials may help to address.

The hydrochloric acid-pumice microabrasion technique in the treatment of post-orthodontic decalcification.

A significant number of patients exhibit white spots of enamel decalcification after orthodontic treatment, despite the use of preventive regimes. The hydrochloric acid-pumice micro-abrasion technique offers a method for improving the appearance of these lesions where they are cosmetically unacceptable. The clinical procedure is described and the effects of the technique upon the dental structures are discussed.